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Background: Cognitive impairments are common in Parkinson's disease (PD). Despite its clinical importance, the development of dementia is still difficult to predict. In this study, we investigated the possible associations between non-motor symptoms and the risk of developing dementia within a 2-year observation period in PD. Methods: A total of 80 patients with PD participated in this study. Nonmotor symptoms (the Nonmotor Symptoms Questionnaire), PD status (Unified Parkinson's Disease Rating Scale), depression (Geriatric d Depression Scale or Montgomery-Asberg Depression Scale), stereopsis and severity of nonmotor symptoms (Non-motor symptoms scale) were assessed. Global cognitive function (Mini-Mental State Examination) were evaluated at baseline and 2 years later. Results: Presence of depression, vivid dreaming, REM sleep behavior disorders, hyposmia, abnormal stereopsis, non-smoking and postural instability/ gait disturbance phenotype were associated with a significantly more rapid decline of Mini-Mental State Examination. Logistic regression analyses demonstrated that depression (odds ratio = 13.895), abnormal stereopsis (odds ratio = 10.729), vivid dreaming (odds ratio = 4.16), REM sleep behavior disorders (odds ratio = 5.353) and hyposmia (odds ratio = 4.911) were significant independent predictors of dementia risk within 2 years. Postural instability/ gait disturbance phenotype and age >62 years were also independent predictors of dementia risk (odd ratio = 38.333, odds ratio = 10.625). Conclusions: We suggest that depression, vivid dreaming, REM sleep behavior disorders, hyposmia and abnormal stereopsis are closely associated with cognitive decline, and that presence of these nonmotor symptoms predict the subsequent development of Parkinson's disease dementia. Résultats: La présence de dépression, de rêves intenses et troublants, de troubles du comportement du sommeil paradoxal, d'hyposmie, d'anomalies de la stéréopsie, le fait d'être non-fumeur et l'instabilité posturale/la démarche anormale étaient associés à un déclin significativement plus rapide du score au Mini-Mental. Les analyses de régression logistique ont montré que la dépression (rapport de cotes (RC) = 13,895), la stéréopsie anormale (RC = 10,729), les rêves intenses et troublants (RC = 4,16), les troubles du comportement du sommeil paradoxal (RC = 5,353) et l'hyposmie (RC = 4,911) prédisaient de façon indépendante le risque de démence au cours des 2 prochaines années. Une instabilité posturale/une démarche anormale et un âge supérieur à 62 ans prédisaient de façon indépendante le risque de démence (RC = 38,333, RC = 10,625). Conclusions: Nous proposons que la dépression, les rêves intenses et troublants, les perturbations du comportement du sommeil paradoxal, l'hyposmie et la stéréopsie anormale sont étroitement associés au déclin cognitif et que la présence de ces symptômes non moteurs prédit l'apparition subséquente de la démence dans la maladie de Parkinson.

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findings from diffusion-weighted imaging (dWi) have been used as indicators of early changes in ischemic brain tissue; several studies have suggested that initial dWi findings can predict the clinical severity and clinical outcomes for a patient. 1-8 a large proportion of these studies included patients with anterior circulation ischemic stroke. 1-6 however, dWi is more useful in detecting infarctions and estimating the severity of ischemic change in patients with posterior circulation ischemic stroke; dWi is more sensitive than computed tomography (Ct) for identifying structures in the posterior fossa. 9,10 few studies have addressed whether lesions assessed ABSTRACT: Background: few studies have addressed the association between the characteristics of ischemic lesions detected by diffusion-weighted imaging (dWi) and the clinical outcome in patients with hyperacute posterior circulation ischemic stroke. this study demonstrates a relationship between the findings assessed by dWi and the outcome in patients with hyperacute posterior circulation ischemic stroke. Methods: We reviewed data from 118 patients who had posterior circulation ischemic stroke within six hours from the onset of their symptoms. the clinical outcome included early neurological deterioration (end) and a favorable outcome at three months after the onset of symptoms. using dWi, the lesion volume and the number and location of injured anatomical regions were analyzed to evaluate whether the results correlated with the clinical outcome measures. Results: the number of injured anatomical regions assessed by dWi was associated with the initial and delayed neurological status. Both the total volume and the number of injured anatomical regions associated with end and a favorable outcome. analysis of the location of the injured regions determined that only a pontine lesion independently associated with end. interestingly, four out of five patients who underwent decompressive craniectomy exhibited a large infarction volume but minor symptoms. Conclusions: in patients with hyperacute posterior circulation ischemic strokes, the lesions assessed by dWi were associated with the clinical outcome, regardless of the initial neurological status. dWi is an effective initial imaging tool for assessing the extent of lesions and clinical outcomes in patients with hyperacute posterior circulation ischemic stroke. RÉSUMÉ: Lésions détectées à l'imagerie pondérée en diffusion (IPD) et issue d'un accident vasculaire hyperaigu au niveau de la circulation postérieure.Contexte : peu d'études ont examiné l'association entre les caractéristiques des lésions ischémiques détectées par imagerie pondérée en diffusion (ipd) et les conséquences cliniques chez les patients présentant un accident vasculaire cérébral (avC) hyperaigu au niveau de la circulation postérieure. Cette étude démontre qu'il existe une relation entre les constatations faites à l'ipd et l'issue chez des patients atteints d'un avC ischémique hyperaigu de la circulation postérieure. Méthode : nous avons revu les...

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